ArticleThe Journal of surgical research2024
Anatomy Versus Biology: What Guides Chemotherapy Decisions in Older Patients With Breast Cancer?
Article in The Journal of surgical research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Development, verification, and comparison of a risk stratification model to identify potential population benefiting from chemotherapy in non-metastatic male breast cancer.Scientific reports · 2025Article
- Adjuvant Radiation vs Endocrine Therapy After Lumpectomy for Early-Stage Breast Cancer in Older Women: Analysis of Real-World Survival Outcomes.Annals of surgical oncology · 2025Article
- ASO Author Reflections: Investigating the Role of Sentinel Lymph Node Biopsy in Older Patients with Triple-Negative Breast Cancer.Annals of surgical oncology · 2024Article
- Utility of Axillary Staging in Older Patients with HER2-Positive Breast Cancer.Annals of surgical oncology · 2024Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
introductionWith the increasing utilization of genomic assays, such as the Oncotype DX recurrence score (RS), the relevance of anatomic staging has been questioned for select older patients with breast cancer. We sought to evaluate differences in chemotherapy receipt and/or survival among older patients based on RS and sentinel lymph node biopsy (SLNB) receipt/result.
methodsPatients aged ≥ 65 diagnosed with pT1-2/cN0/M0 hormone-receptor-positive (HR+)/HER2-breast cancer (2010-2019) were selected from the National Cancer Database. Logistic regression was used to identify factors associated with chemotherapy receipt. Cox proportional hazards models were used to estimate the association of RS/SLNB group with overall survival. A cost-benefit study was also performed.
resultsOf the 75,428 patients included, the majority had an intermediate RS (58.2% versus 27.9% low, 13.8% high) and were SLNB- (85.1% versus 11.6% SLNB+, 3.3% none). Chemotherapy was recommended for 13,442 patients (17.8%). After adjustment, chemotherapy receipt was more likely with higher RS and SLNB+. After adjustment, SLNB receipt/result was only associated with overall survival among those with an intermediate RS. However, returning to the OR for SLNB is not cost-effective.
conclusionsSLNB receipt/result was associated with survival for those with an intermediate RS, but not a low or high RS, suggesting that an SLNB may indeed be unnecessary for select older patients with breast cancer.
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